Bahadur Madhav, Singh Paramjeet, Satyawali Vivekanand, Joshi Arun
Department of Medicine, Government Medical College, Haldwani, Uttarakhand 263139 India.
Indian J Orthop. 2020 Mar 10;54(4):513-517. doi: 10.1007/s43465-020-00077-8. eCollection 2020 Jul.
Rheumatoid arthritis (RA) is a symmetric poly-arthritis predominantly affecting the small synovial joints, although any synovial joint can be involved. The underlying cause is not known; however, predilection for the disease is impacted by genetic and environmental factors. Several factors predict disease severity in RA including development of erosions, female sex and duration of disease. This study evaluates the role of disease duration, early initiation of disease modifying anti-rheumatic drugs (DMARDs) and auto-antibodies like rheumatoid factor in predicting erosive disease in Indian patients with rheumatoid arthritis.
A 2-year hospital-based cross-sectional observational study was conducted in the Department of Medicine in a tertiary care centre in Kumaon region of Uttarakhand in northern India. 260 patients diagnosed with RA on the basis of 2010 ACR/EULAR criteria were included.
A total of 135 patients had erosive disease, with DMARD naive median period of 3 years compared to 125 patients with non-erosive disease, with DMARD naive median period of 2 years. On the basis of this data and after evaluation for radiographic erosions, it was found that a longer DMARD naive period predicts higher odds of developing erosive disease.
Early diagnosis of rheumatoid arthritis and initiation of DMARDs is crucial in increasing quality of life and preventing severe disease with deformities, erosive changes and extra-articular manifestations.
类风湿关节炎（RA）是一种对称性多关节炎，主要影响小滑膜关节，不过任何滑膜关节都可能受累。其根本病因尚不清楚；然而，遗传和环境因素会影响该病的易感性。类风湿关节炎的疾病严重程度可由多个因素预测，包括出现侵蚀、女性性别和病程。本研究评估病程、早期启用改善病情抗风湿药物（DMARDs）以及类风湿因子等自身抗体在预测印度类风湿关节炎患者侵蚀性疾病方面的作用。
在印度北部北阿坎德邦库马翁地区一家三级医疗中心的内科开展了一项为期2年的基于医院的横断面观察性研究。纳入了260例根据2010年美国风湿病学会/欧洲抗风湿病联盟（ACR/EULAR）标准确诊为RA的患者。
共有135例患者患有侵蚀性疾病，未使用DMARDs的中位病程为3年，而125例非侵蚀性疾病患者未使用DMARDs的中位病程为2年。根据这些数据并经影像学侵蚀评估后发现，未使用DMARDs的病程较长预示发生侵蚀性疾病的几率更高。
类风湿关节炎的早期诊断和启用DMARDs对于提高生活质量以及预防出现畸形、侵蚀性改变和关节外表现的严重疾病至关重要。
